Individual provider Active NPI

Kara Johnson, AGNP-BC

  • Adult Health Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1023699535
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310182 Issued in NY
Practice address
400 International Dr
Williamsville, NY 14221-5771
Phone
(716) 631-3555
Fax
(716) 631-9525
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F310182 NY Primary

Addresses

Primary practice location

400 International Dr
Williamsville, NY 14221-5771

Mailing address

400 International Dr
Williamsville, NY 14221-5771
Phone (716) 631-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427000386 NY Practitioner - Nurse Practitioner 3072921345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F310182NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care of Western New York LLP CurrentSince May 1, 2021 Accepting new patients
Christopher E. Beney, MD, PC CurrentSince Jul 18, 2022 Accepting new patients
Digestive Health Physicians, P.C. PastSince Apr 1, 2021 Accepting new patients

Locations

5007 Transit Rd
Depew, NY 14043
Phone (716) 650-5516

1149 Lincoln Ave
Lockport, NY 14094
Phone (716) 433-2674

30 N Union Rd
Ste 102
Williamsville, NY 14221
Phone (716) 839-8000

30 N Union Rd
Williamsville, NY 14221
Phone (716) 633-6363

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1023699535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-631-3555",
            "fax_number": "716-631-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KARA",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.